Postural compensation for vestibular loss.
Postural compensation for vestibular loss.
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DOI：
10.1111/j.1749-6632.2008.03708.x
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发表时间：
2009-05
影响因子：
5.2
通讯作者：
Horak FB
中科院分区：
文献类型：
--
作者：
Horak FB
在控制姿势平衡的过程中，残留的感觉信息和/或感觉生物反馈能在多大程度上弥补前庭信息的损失？前庭脊髓系统的主要作用是在空间中作为控制躯干的垂直参照，随着表面变得越来越不稳定，其重要性越来越大。我们对双侧前庭功能丧失患者的研究表明，当站在不稳定的表面时，指尖的视觉或光触摸可以代替地面垂直，以减少躯干摇摆的变异性。然而，一些双侧丧失的患者比其他患者补偿得更好，我们发现那些双侧前庭功能更完全丧失的患者比那些可测量到的前庭-眼睛反射的患者补偿得更好。相比之下，单侧前庭功能丧失的患者在不稳定的表面上不增加前庭重量的患者相比，重新调整感觉依赖以依赖其剩余的单侧前庭功能的患者表现出更好的功能表现。轻触100克或听觉生物反馈可以作为前庭垂直参考，以稳定站立时躯干的摇摆。单侧前庭缺失患者在串联步态中的姿势共济失调也通过振动触觉生物反馈到躯干得到显著改善，这超出了练习的改善范围。前庭康复的重点应该是减少过多的宫缩，减少对表面体感输入的过度依赖，增加对任何剩余的前庭功能的使用，取代或增加与躯干摆动有关的替代感觉反馈，以及在不稳定的表面上练习挑战性的平衡任务。
To what extent can remaining sensory information and/or sensory biofeedback compensate for loss of vestibular information in controlling postural equilibrium? The primary role of the vestibulospinal system is as a vertical reference for control of the trunk in space, with increasing importance as the surface becomes increasingly unstable. Our studies with patients with bilateral loss of vestibular function show that vision or light touch from a fingertip can substitute as a reference for earth vertical to decrease variability of trunk sway when standing on an unstable surface. However, some patients with bilateral loss compensate better than others and we find that those with more complete loss of bilateral vestibular function compensate better than those with measurable vestibulo-ocular reflexes. In contrast, patients with unilateral vestibular loss who reweight sensory dependence to rely on their remaining unilateral vestibular function show better functional performance than those who do not increase vestibular weighting on an unstable surface. Light touch of <100 grams or auditory biofeedback can be added as a vestibular vertical reference to stabilize trunk sway during stance. Postural ataxia during tandem gait in patients with unilateral vestibular loss is also significantly improved with vibrotactile biofeedback to the trunk, beyond improvements due to practice. Vestibular rehabilitation should focus on decreasing hypermetria, decreasing an over-dependence on surface somatosensory inputs, increasing use of any remaining vestibular function, substituting or adding alternative sensory feedback related to trunk sway, and practicing challenging balance tasks on unstable surfaces.
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影响因子：
--
作者：
Cohen, HS;Kimball, KT
通讯作者：
Kimball, KT
影响因子：
2
作者：
Creath, R;Kiemel, T;Jeka, JJ
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2
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Chiari, Lorenzo
DOI：
10.1093/gerona/50a.1.m28
发表时间：
1995-01-01
影响因子：
5.1
作者：
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通讯作者：
MYERS, AM
影响因子：
2.5
作者：
INGLIS, JT;MACPHERSON, JM
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